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Grange Cottage Residential Home Good


Inspection carried out on 29 January 2021

During an inspection looking at part of the service

Grange Cottage Residential Home is a 'care home' providing accommodation and support for older people and people living with dementia. The service can support up to 33 people. At the time of our inspection there were 33 people living in the home.

We found the following examples of good practice.

People were in contact with their families. Relatives could have window visits and people receiving end of life care were able to have visits in their rooms. Staff screened visitors to the service for symptoms of infection and visitors that had not already had a COVID-19 test were tested using lateral flow tests. Families had been provided with information about the safety procedures visitors should follow to ensure their safety and the safety of residents and staff. When relatives were not able to visit, they kept in touch with people through video and telephone calls.

Residents and staff were tested for COVID-19 in line with current government guidance.

All staff had been trained in infection prevention and control (IPC) and the use of personal protective equipment (PPE). There were designated areas for staff to don and doff PPE and hand sanitising and washing facilities were easily accessible to people, staff and visitors. There were COVID-19 and hand washing information signs throughout the home. We observed staff followed current IPC guidance and practice throughout our visit. Staff only worked at this location and did not work at any other locations. This reduced the risk of staff spreading infection between locations.

The service's IPC policy was up to date and in line with current guidance.

The service had plans in place to respond immediately and appropriately to an outbreak of infection to ensure the safety of people and staff.

Further information is in the detailed findings below.

Inspection carried out on 16 January 2020

During a routine inspection

About the service

Grange Cottage Residential Home is a residential care home providing personal care for up to 33 people who are living with dementia. At the time of our inspection 29 people were using the service.

People’s experience of using this service and what we found

People were happy living at Grange Cottage. Relatives told us they felt their family members were safe and well cared for. Staff knew how to keep people safe, they knew the risks people faced and how to manage those risks. Staff made sure people received their medicine in a safe way. There was enough staff to meet people’s needs and the recruitment process checked staff to make sure they were safe to support people.

Staff had regular training to make sure their skills and knowledge were up to date. Staff supported people to see healthcare professionals when they needed to. People told us they enjoyed the food at Grange Cottage and could choose what they wanted to eat. People’s likes, dislikes, cultural and religious needs were catered for. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People and their relatives thought staff were kind and caring. Staff helped people keep in contact with their family and friends. Care records helped staff know what was important to people and how they wanted to be supported. Information was available for people in a way they could understand.

Managers and staff made sure people were asked their views about how the service was run and what staff could do to make things better. Managers and staff knew how to record and report concerns, this included any safeguarding concerns. When an incident or accident happened, the reason was investigated and changes were made to make things better for people.

For more details, please see the full report which is on the CQC website at

Rating at last inspection

The last rating for this service was good (published 30 August 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 20 July 2017

During a routine inspection

This inspection took place on 20 July 2017. At our previous inspection in April 2015 the service was rated as good. Grange Cottage now provides personal care and support for up to 33 people some of whom are living with dementia or mental health problems. Since the last inspection the provider increased their bed capacity from 19 people by extending the care home to the property next door. On the day of our inspection 19 people were using the service.

At the time of the inspection, there was a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People felt safe and were supported by staff who knew how to keep them safe. Risks to people's health and safety were assessed and appropriately managed and people were supported by sufficient numbers of staff. Robust staff recruitment procedures helped to keep people safe. People received the support they needed to safely manage their medicines.

Staff had the knowledge and skills to care for people effectively and felt well supported by appropriate training and effective supervision. People were all able to make choices and decisions about their care sometimes with the support of their relatives. People received support where they needed it to access a range of healthcare services.

Relatives and professionals told us staff were consistently kind and caring and established positive relationships with people and their families. Staff valued people, treated them with respect and promoted their rights, choices and independence.

People's needs were fully assessed with them before they moved to the home to make sure that the home could meet their needs. Assessments were reviewed with the person and their relatives. People were encouraged to take part in activities and leisure pursuits of their choice.

People knew who to talk to if they had a complaint. Complaints were managed in accordance with the provider's complaints policy.

People spoke positively about the way the home was run. The management team and staff understood their respective roles and responsibilities. Staff told us that the registered manager was very approachable and understanding.

There were effective systems in place to monitor and improve the quality of the service provided. We saw that various audits had been undertaken.

The registered manager was not aware of when notifications had to be sent to CQC and thought they should be sent only to the local authorities. When we explained the purpose of these notifications the registered manager and the home’s administrator acknowledged the need to do this and agreed to implement this requirement with immediate effect.

Inspection carried out on 30 April 2015

During a routine inspection

This unannounced inspection took place on the 30 April 2015. At our last inspection on 1 May 2014 we found no breaches of legislation.

Grange Cottage is a care home providing personal care for up to 19 people living with dementia. The home was fully occupied on the day of our visit.

The service has a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Grange Cottage is run by a limited company which consists of a husband and wife team. Mrs Halkoree is the registered manager and her husband is the deputy manager. Mr Halkoree is also a director of the service.

Grange Cottage is a care home that provides accommodation for personal care. The accommodation was arranged over two floors. The home had a stair lift that ensured people could move freely between floors. There was also wheelchair access to the garden.

The provider had ensured that only suitably recruited staff were employed. They had undertaken a number of checks to make sure staff were safe and had the qualities required to undertake their role. Staff once recruited had an induction period so they became familiar with the service. They also received training to ensure they had sufficient skills to undertake their role. This training was regularly refreshed so that it continued to be in line with current best practice. There were sufficient staff on duty to meet people’s needs.

People were helped to maintain good health. This included being supported to have access to healthcare professionals and receiving their prescribed medicines when they should.

There was a choice of meals, snacks and drinks. Staff supported people to eat and drink sufficient amounts to maintain their health and well-being.

The provider was aware of their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). DoLS provides a process to make sure people are only deprived of their liberty in a safe and correct way. Staff had received training and applications had been appropriately made to the local authority. People were asked for their consent to care and treatment prior to it been given.

People were positive about the service and felt they could raise any issues with the registered manager or other staff members. There was a complaints procedure in place and people were encouraged to say what they thought of the service provided.

The provider was continually monitoring all aspects of the care through various audits, checks and surveys to make sure they were in line with best practice.

Everyone living at Grange Cottage had an individualised record of their needs and how they wanted to be cared for. These records were continually updated so they reflected people’s current and changing needs and wishes. The provider understood people were all individual and had different interests, so as far as possible they offered a range of activities and social outings for people to participate in.

People were supported to maintain contact with people that were important to them. Relatives told us how welcoming the home was and how there was no restrictions on when they visited.

Staff knew the people they were caring for and treated them with dignity and respect. People were encouraged and supported to be as independent as possible so they retained their dignity and choice wherever they could.

Inspection carried out on 1 May 2014

During a routine inspection

We spoke with four people and observed staff interactions. We looked at care records for three people and spoke with two members of staff and the deputy manager. We had the opportunity to talk with a relative visiting someone who lived at the service.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask:

� Is the service caring?

� Is the service responsive?

� Is the service safe?

� Is the service effective?

� Is the service well led?

Below is a summary of what we found. If you want to see evidence supporting our summary please read the full report.

Is the service safe?

People using the service told us they felt safe and that they were cared for individually. Assessments were carried out by staff to make sure that people�s needs were identified and met. Risks were assessed and reviewed regularly to make sure people�s changing needs were met. People were involved in making decisions about how they wanted to be cared for. People were supported to take their medicines in a safe way.

Staff had undertaken training in the Mental Capacity Act (2005) and were aware of their responsibilities in relation to the Deprivation of Liberty Safeguards (DoLS); although no application has needed to be submitted to the local authority.

There were systems in place to ensure that management and staff learnt from events that adversely affected the people using the service.

Is the service effective?

People received effective care from staff that were trained and supported by the manager. People were involved in assessments of their health and care needs and in writing their plan of care so they understood the information they included.

Staff encouraged and supported people to keep healthy and well through regular monitoring of people�s general health and making sure they attended scheduled medical and healthcare appointments.

Is the service caring?

People were supported by attentive and patient staff. We saw them give encouragement to people and these interactions were caring and compassionate. Staff respected peoples� privacy, dignity and right to be involved in decisions and make choices about their care and treatment.

All the people we spoke with gave us positive feedback on the care and support they received in the home. Comments we received included, "staff are good� and �they do the best they can�.

Is the service responsive?

We found staff continually monitored people�s condition and where necessary sought advice and assistance from other community based health and social care professionals.

The views of the people using the service and their relatives were routinely sought by the provider who regularly had contact with them and also used annual questionnaires to their ascertain views. People we spoke with knew how they could make a complaint if they were dissatisfied or unhappy with the service they received.

Is the service well led?

The service had a registered manager who was experienced and knew the service well.

The provider carried out regular checks to assess and monitor the quality of the service provided. In this way the provider could ensure that the quality of the service was maintained.

Staff told us they were clear about their roles and responsibilities. Staff felt able to raise concerns and said that their manager was approachable and would act upon any concerns they raised.

Inspection carried out on 20 August 2013

During an inspection looking at part of the service

This visit was a follow up from a previous inspection undertaken on the 16th April 2013. During that inspection we did not consider that the home was meeting minimum standards as laid out by legislation and therefore made two compliance actions. These actions required the provider to tell us in a report how they would meet these standards. This inspection was undertaken to check that they had complied with what we had required of them.

We made two compliance actions at our previous inspection. One related to medication, the other quality assurance. After our visit we concluded that the provider had met the minimum standards required of them and therefore both compliance actions had been removed.

To get full picture of the home and how it functioned, the reader is advised to read this report in conjunction with report written following our visit on the 16th April.

Inspection carried out on 16 April 2013

During a routine inspection

We found that the home had a relaxed, friendly and warm atmosphere. There was a lot of caring interaction between staff and people who used the service. Staff that were on duty had a good understanding of people�s needs and were able to respond appropriately.

The paperwork relating to people who lived at the home was comprehensive, up to date and accurate.

There were some areas that the home needed to focus on in order to meet minimum standards of care. These have been outlined in the body of the report or as compliance actions at the end of the report.

Inspection carried out on 10 May 2012

During a routine inspection

We spoke to 6 people out of the 18 that are currently living at Grange Cottage, one relative and various staff members including the manager and deputy.

People told us �staff are good� and �they�re very good here and I�ve been given a lot of help�.

To help us to understand the experiences people have at Grange Cottage, we also used our SOFI (Short Observational Framework for Inspection) tool. The SOFI tool allows us to spend time watching what is going on in a service and helps us to record how people spend their time.

Inspection carried out on 24 November 2010

During an inspection in response to concerns

People we met told us that staff always treated them well and listened to what they had to say. Comments included, �they look after us well here�, �the staff are good and kind� and �I like it here�.

With regard to the food and drink that people are given, comments included the �foods very good�, �sometimes in the evening we get sandwiches, but not often and not when it�s cold� and the �food is alright�.

People told us that usually there are enough members of staff on duty. People also told us about the new activities co-ordinator, who they were positive about. One person who lives in the home was able to tell us how they are able to go out whenever they want to, usually to the shops.

Finally, we were reassured by the comments made by the deputy manager that acknowledged the improvements that had been made to the service. In addition, there remained a commitment to the home and to its continued development as a service.

Reports under our old system of regulation (including those from before CQC was created)